Provider Demographics
NPI:1376979500
Name:BANALES, SANDRA
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:
Last Name:BANALES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3755 ALHAMBRA AVE
Mailing Address - Street 2:SUITE 9
Mailing Address - City:MARTINEZ
Mailing Address - State:CA
Mailing Address - Zip Code:94553-3833
Mailing Address - Country:US
Mailing Address - Phone:925-646-2305
Mailing Address - Fax:925-646-1552
Practice Address - Street 1:3755 ALHAMBRA AVE
Practice Address - Street 2:SUITE 9
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-3833
Practice Address - Country:US
Practice Address - Phone:925-646-2305
Practice Address - Fax:925-646-1552
Is Sole Proprietor?:No
Enumeration Date:2013-09-19
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor